Access to healthcare by using smart ID card
63
Access to healthcare by Access to healthcare by using smart ID card using smart ID card Netnapis Netnapis Suchonwanich Suchonwanich National Health Security Office National Health Security Office
Transcript of Access to healthcare by using smart ID card
Health Insurance In ThailandAccess to healthcare by Access to
healthcare by using smart ID cardusing smart ID card
NetnapisNetnapis SuchonwanichSuchonwanich National Health Security OfficeNational Health Security Office
Contents
Office (NHSO)
ID card.
care scheme.
National Health Security office (NHSO)
NHSO is a state agency, officially founded in 2002, under the National Health Security Act.
It is responsible for the health security of 47.5 million Thai citizens. Every person born as a Thai should feel secure, irrespective of being sick or not .
National Health Security office (NHSO)
The mandatory duties of NHSO are to manage the
health security fund and allocate the subsidiary budget
to 236 clinics and 963 hospitals to promote and develop
a good health care system for all Thai people.
In order to assure the quality of care provided to UC’s
members, NHSO has to control and supervise health
care units to achieve the required standards of health
services for all members.
Social Security Scheme
Voluntary health insurance
Transition of Health Insurance status in Thailand
Universal Coverage Scheme
27.5 M. (43.7%)
5.2 M. (8.2%)
15.2 M. (24.1%)
8.5 M. (13.5%)
6.6 M. (10.5%)
47 M. (74.60%)
8 M. (12.7%)
Social security scheme
Universal coverage scheme
Safety Net
Some of Thai people have no personal identification numbers (PID)
Dynamic personal data which affects eligibility (such as birth, death, apply or retire from a job, migrant status)
People with multiple health insurance status.
Poor database & poor data communication among other healthcare schemes resulted in incomplete integration of national health insurance population data.
The situation at the beginning of The situation at the beginning of Universal CoverageUniversal Coverage implementationimplementation
The situation at the beginning of The situation at the beginning of Universal CoverageUniversal Coverage implementationimplementation
Weakness of IT infrastructure
No reliable backup system
No standard data set for each system
People who were no longer eligible were claiming from health insurance schemes
People who were covered by more than one scheme were submitting claims to both schemes
The new Era of Information System
in NHSO
C ustom
NHSO Core Businesses
Universal Coverage Scheme Universal Coverage Scheme from policy to implementationfrom policy to implementation
In 2003, the Bureau of IT management of NHSO has to established the NHSO IT master plan in order to meet the needs of the core business ,the awareness of information security and the privacy of personal data.
According to the NHSO IT master plan, the strategies were well designed for
- Database architecture
- Network architecture
- Application architecture
Strategies for Strategies for NHNHSOSO information systeminformation system
Centralized database Centralized data processing Use high speed Internet for connection among the providers and leased line for linking all of the branch offices Integrated software system covering all of the NHSO businesses and links with other medical care scheme (e.g. CSMBS, SSS) Establish computer security system
Operational Part Analytical Part
Warehouse Data Mart Business
Network architectureNetwork architecture
(256-512 Kbps)
NHSO BranchesNHSO
BranchesNHSO BranchesNHSO
BranchesNHSO BranchesNHSO
Write Once,Write Once, Multiple usagesMultiple usages
There must be no redundant data written to the databases.
Application architectureApplication architecture
Mod.7 Call Center
Mod.8 MIS&EIS
Moving from UC cardMoving from UC card to Smart ID card to Smart ID card
Sub-district Health Center
First implementation of smart ID card in Thailand
“One card does it all” is the challenging purpose of Thai government to
integrate the official paper cards into only one smart card
12 million “smart” ID cards costing 888 million baht were issued in the year
2005 in order to replace the national ID card and consolidate multiple
health cards and official information from many government offices.
The 1 st Smart ID card is a microcontroller- based card and has 64 kilobytes
(KB) of memory
Lessons learnt from the first version of smart ID cards
Lessons learnt from the first version of smart ID cards
The first version of smart ID cards failed to meet the designed requirements and resulted in controversial discussion among the experts, especially relating to security acceptance tests and insufficient memory provided for other departments.
So, the specification of smart ID card has been corrected and the second procurement has been conducted again in order to replace the first lot .
22
D S - 3D S - 3
A D S L
T e l e p h o n e
T e r m i n a l S e r v e r
R A D I U S / L D A P
E 1
E 1
verificationPo pu
la tio
National ID card
The development of national ID cardThe development of national ID card
Paper card
Plastic card
1 st Smart ID card 2 nd Smart ID card
How to verify the beneficiaries
beneficiaries with no ID card
beneficiaries with ID card
Card reader
In order to achieve the implementation of using
smart ID card for access the healthcare services
in UC scheme. The government has to issue the
new act for national ID card by compulsory
registration for Thai citizen since birth until
death.
28
Card reader The ministry of ICT has provided more than 15,000 card readers to every provider so that all of the providers can retrieve the data from the smart ID card.
If any providers can connect to the internet , the data embedded in the microchip will be updated through the web application developed by MOI.
Population database
The population database
Every 15 days, NHSO has to exchange the beneficiaries’ data with other health care schemes. Every day, the dynamic data such as birth and dead status which is very significant to the enrollment system will be updated from the ministry of interior (MOI). In the other hands, the eligibilities of the beneficiaries will be updated to the MOI’s server
Beneficiary enrollment SystemBeneficiary enrollment System
Social Security OfficeSocial Security Office
Civil Servant Civil Servant
Internet
Beneficiary verification
Beneficiary verification Every provider can verify the beneficiaries by key in 13 digits from ID card in the NHSO’s website. Moreover, the providers can also verify the beneficiaries in group by using web services.
1313--digit Personal ID (PID)digit Personal ID (PID)
Search ButtonSearch Button
( .)
Information of UC Information of UC Scheme from NHSO Scheme from NHSO
head office head office
Concurrent retrieves data from 2 remote sites database : MOI , NHSO
First NameFirst Name Last NameLast Name Search ButtonSearch Button
PID First name Last name
Birth Date Address
9.73
8.74
1.34
0.130.34 0.52 0.18 0.1 0.18 0.060.06 0.08 0.13 0.45 0.820.49 0.29 0.1 0.09 8 0.070.04
7 0.04
3 0.03
Smart Card Application
Hospital information system
NHSO Web service
Support many platforms
Retrieve the beneficiaries’ data
Benefit from using smart card
Patient’s registration
dispensing data
Self service for civil registration1. Goto https://eservice.dopa.go.th
Self service for civil registration
3. Select the update menu
Self service for civil registration
Self service for civil registration
4. Update smart ID card
Network
D S - 3D S - 3
A D S L
T e l e p h o n e
T e r m i n a l S e r v e r
R A D I U S / L D A P
E 1
E 1
providers No. of providers
with internetregion province sites %
83 83(100)
60 45(75)
195 57(29.23)
121 121(100)
district health offices don’t have availabilities
to connect the internet.
key success factors for achievement of the
implementation of smart ID card for access
the healthcare services effectively in the
future.
Medical Record Database - Scheme Verification - DRG Grouping, Data Validation - Deny, Warning, Report
(approx. IP : 5,500,000 records/year OP(HC,AE) : 600,000 records/year)
Reimbursement Database - Verification according to Payment Rules - How much to reimburse ? - Reports on website
In te
rn et
In te
rn et
Individual records in NHSO
1. Leukemia 2. Lymphoma 3. Haemophilia 4. Heart surgery 5. Epilepsy 6. Cataract 7. Cleft palate 8. HIV 9. Diabetes Mellitus
hypertension & dyslipidemia
1. Screening for metabolic syndromes (sss, csmbs)
2. Screening for stroke 3. Thalassemia 4. Vaccine 5. Thyroid 6. Screening for CA cervix 7. Disabilities 8. Sealant 9. Denture in elderly
disease management
Prevention & Promotion
1. Pre-hospital care (EMS) 2. Trauma 3. Poisoning 4. Stroke
Emergency care
Citizen Profile ConceptCitizen Profile Concept
Using PID as main linkageUsing PID as main linkage--keykey Individual records stored as isIndividual records stored as is Retrieving individual health data Retrieving individual health data from various databasesfrom various databases Chronologically Rearrangement of Chronologically Rearrangement of data to create individual citizen data to create individual citizen profile that can describe full history profile that can describe full history of the patient possessing this PIDof the patient possessing this PID
Beneficiaries
Consolidation of the citizen profiles Consolidation of the citizen profiles
IP individual
OP individual
Screening data
NHSO Data CenterNHSO Data Center
Data Center ProjectData Center Project
Provide sufficient and effective hardwares for the continuity of core business chain of NHSO
Centralized Database and centralized processing
Integrate the core business modules for seamless processing.
Establish national health services schema for data exchange with other health schemes in the future.
Information technology infrastructures and computer networks have been constantly supported
Data warehouse Data warehouse
Enterprise Data Warehouse
Ad hoc Query
Access to healthcare by using smart ID card
Contents
Transition of Health Insurance status in Thailand
The situation at the beginning of Universal Coverage implementation
The situation at the beginning of Universal Coverage implementation
The new Era ofInformation Systemin NHSO
Universal Coverage Scheme from policy to implementation
Strategies for NHSO information system
Network architecture
Lessons learnt from the first version of smart ID cards
The essential components
National ID card
How to verify the beneficiaries
The suggestion for smart ID card
Card reader
Card reader
Population database
Decrease in beneficiary enrollment errors from 2002-2005
The perspective for medical visit byusing smart card in the future
How to update smart ID card
Self service for civil registration
Self service for civil registration
Network
The suggestion for network
Analysis
NetnapisNetnapis SuchonwanichSuchonwanich National Health Security OfficeNational Health Security Office
Contents
Office (NHSO)
ID card.
care scheme.
National Health Security office (NHSO)
NHSO is a state agency, officially founded in 2002, under the National Health Security Act.
It is responsible for the health security of 47.5 million Thai citizens. Every person born as a Thai should feel secure, irrespective of being sick or not .
National Health Security office (NHSO)
The mandatory duties of NHSO are to manage the
health security fund and allocate the subsidiary budget
to 236 clinics and 963 hospitals to promote and develop
a good health care system for all Thai people.
In order to assure the quality of care provided to UC’s
members, NHSO has to control and supervise health
care units to achieve the required standards of health
services for all members.
Social Security Scheme
Voluntary health insurance
Transition of Health Insurance status in Thailand
Universal Coverage Scheme
27.5 M. (43.7%)
5.2 M. (8.2%)
15.2 M. (24.1%)
8.5 M. (13.5%)
6.6 M. (10.5%)
47 M. (74.60%)
8 M. (12.7%)
Social security scheme
Universal coverage scheme
Safety Net
Some of Thai people have no personal identification numbers (PID)
Dynamic personal data which affects eligibility (such as birth, death, apply or retire from a job, migrant status)
People with multiple health insurance status.
Poor database & poor data communication among other healthcare schemes resulted in incomplete integration of national health insurance population data.
The situation at the beginning of The situation at the beginning of Universal CoverageUniversal Coverage implementationimplementation
The situation at the beginning of The situation at the beginning of Universal CoverageUniversal Coverage implementationimplementation
Weakness of IT infrastructure
No reliable backup system
No standard data set for each system
People who were no longer eligible were claiming from health insurance schemes
People who were covered by more than one scheme were submitting claims to both schemes
The new Era of Information System
in NHSO
C ustom
NHSO Core Businesses
Universal Coverage Scheme Universal Coverage Scheme from policy to implementationfrom policy to implementation
In 2003, the Bureau of IT management of NHSO has to established the NHSO IT master plan in order to meet the needs of the core business ,the awareness of information security and the privacy of personal data.
According to the NHSO IT master plan, the strategies were well designed for
- Database architecture
- Network architecture
- Application architecture
Strategies for Strategies for NHNHSOSO information systeminformation system
Centralized database Centralized data processing Use high speed Internet for connection among the providers and leased line for linking all of the branch offices Integrated software system covering all of the NHSO businesses and links with other medical care scheme (e.g. CSMBS, SSS) Establish computer security system
Operational Part Analytical Part
Warehouse Data Mart Business
Network architectureNetwork architecture
(256-512 Kbps)
NHSO BranchesNHSO
BranchesNHSO BranchesNHSO
BranchesNHSO BranchesNHSO
Write Once,Write Once, Multiple usagesMultiple usages
There must be no redundant data written to the databases.
Application architectureApplication architecture
Mod.7 Call Center
Mod.8 MIS&EIS
Moving from UC cardMoving from UC card to Smart ID card to Smart ID card
Sub-district Health Center
First implementation of smart ID card in Thailand
“One card does it all” is the challenging purpose of Thai government to
integrate the official paper cards into only one smart card
12 million “smart” ID cards costing 888 million baht were issued in the year
2005 in order to replace the national ID card and consolidate multiple
health cards and official information from many government offices.
The 1 st Smart ID card is a microcontroller- based card and has 64 kilobytes
(KB) of memory
Lessons learnt from the first version of smart ID cards
Lessons learnt from the first version of smart ID cards
The first version of smart ID cards failed to meet the designed requirements and resulted in controversial discussion among the experts, especially relating to security acceptance tests and insufficient memory provided for other departments.
So, the specification of smart ID card has been corrected and the second procurement has been conducted again in order to replace the first lot .
22
D S - 3D S - 3
A D S L
T e l e p h o n e
T e r m i n a l S e r v e r
R A D I U S / L D A P
E 1
E 1
verificationPo pu
la tio
National ID card
The development of national ID cardThe development of national ID card
Paper card
Plastic card
1 st Smart ID card 2 nd Smart ID card
How to verify the beneficiaries
beneficiaries with no ID card
beneficiaries with ID card
Card reader
In order to achieve the implementation of using
smart ID card for access the healthcare services
in UC scheme. The government has to issue the
new act for national ID card by compulsory
registration for Thai citizen since birth until
death.
28
Card reader The ministry of ICT has provided more than 15,000 card readers to every provider so that all of the providers can retrieve the data from the smart ID card.
If any providers can connect to the internet , the data embedded in the microchip will be updated through the web application developed by MOI.
Population database
The population database
Every 15 days, NHSO has to exchange the beneficiaries’ data with other health care schemes. Every day, the dynamic data such as birth and dead status which is very significant to the enrollment system will be updated from the ministry of interior (MOI). In the other hands, the eligibilities of the beneficiaries will be updated to the MOI’s server
Beneficiary enrollment SystemBeneficiary enrollment System
Social Security OfficeSocial Security Office
Civil Servant Civil Servant
Internet
Beneficiary verification
Beneficiary verification Every provider can verify the beneficiaries by key in 13 digits from ID card in the NHSO’s website. Moreover, the providers can also verify the beneficiaries in group by using web services.
1313--digit Personal ID (PID)digit Personal ID (PID)
Search ButtonSearch Button
( .)
Information of UC Information of UC Scheme from NHSO Scheme from NHSO
head office head office
Concurrent retrieves data from 2 remote sites database : MOI , NHSO
First NameFirst Name Last NameLast Name Search ButtonSearch Button
PID First name Last name
Birth Date Address
9.73
8.74
1.34
0.130.34 0.52 0.18 0.1 0.18 0.060.06 0.08 0.13 0.45 0.820.49 0.29 0.1 0.09 8 0.070.04
7 0.04
3 0.03
Smart Card Application
Hospital information system
NHSO Web service
Support many platforms
Retrieve the beneficiaries’ data
Benefit from using smart card
Patient’s registration
dispensing data
Self service for civil registration1. Goto https://eservice.dopa.go.th
Self service for civil registration
3. Select the update menu
Self service for civil registration
Self service for civil registration
4. Update smart ID card
Network
D S - 3D S - 3
A D S L
T e l e p h o n e
T e r m i n a l S e r v e r
R A D I U S / L D A P
E 1
E 1
providers No. of providers
with internetregion province sites %
83 83(100)
60 45(75)
195 57(29.23)
121 121(100)
district health offices don’t have availabilities
to connect the internet.
key success factors for achievement of the
implementation of smart ID card for access
the healthcare services effectively in the
future.
Medical Record Database - Scheme Verification - DRG Grouping, Data Validation - Deny, Warning, Report
(approx. IP : 5,500,000 records/year OP(HC,AE) : 600,000 records/year)
Reimbursement Database - Verification according to Payment Rules - How much to reimburse ? - Reports on website
In te
rn et
In te
rn et
Individual records in NHSO
1. Leukemia 2. Lymphoma 3. Haemophilia 4. Heart surgery 5. Epilepsy 6. Cataract 7. Cleft palate 8. HIV 9. Diabetes Mellitus
hypertension & dyslipidemia
1. Screening for metabolic syndromes (sss, csmbs)
2. Screening for stroke 3. Thalassemia 4. Vaccine 5. Thyroid 6. Screening for CA cervix 7. Disabilities 8. Sealant 9. Denture in elderly
disease management
Prevention & Promotion
1. Pre-hospital care (EMS) 2. Trauma 3. Poisoning 4. Stroke
Emergency care
Citizen Profile ConceptCitizen Profile Concept
Using PID as main linkageUsing PID as main linkage--keykey Individual records stored as isIndividual records stored as is Retrieving individual health data Retrieving individual health data from various databasesfrom various databases Chronologically Rearrangement of Chronologically Rearrangement of data to create individual citizen data to create individual citizen profile that can describe full history profile that can describe full history of the patient possessing this PIDof the patient possessing this PID
Beneficiaries
Consolidation of the citizen profiles Consolidation of the citizen profiles
IP individual
OP individual
Screening data
NHSO Data CenterNHSO Data Center
Data Center ProjectData Center Project
Provide sufficient and effective hardwares for the continuity of core business chain of NHSO
Centralized Database and centralized processing
Integrate the core business modules for seamless processing.
Establish national health services schema for data exchange with other health schemes in the future.
Information technology infrastructures and computer networks have been constantly supported
Data warehouse Data warehouse
Enterprise Data Warehouse
Ad hoc Query
Access to healthcare by using smart ID card
Contents
Transition of Health Insurance status in Thailand
The situation at the beginning of Universal Coverage implementation
The situation at the beginning of Universal Coverage implementation
The new Era ofInformation Systemin NHSO
Universal Coverage Scheme from policy to implementation
Strategies for NHSO information system
Network architecture
Lessons learnt from the first version of smart ID cards
The essential components
National ID card
How to verify the beneficiaries
The suggestion for smart ID card
Card reader
Card reader
Population database
Decrease in beneficiary enrollment errors from 2002-2005
The perspective for medical visit byusing smart card in the future
How to update smart ID card
Self service for civil registration
Self service for civil registration
Network
The suggestion for network
Analysis
